This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, March 03, 2014

Weekly Australian Health IT Links – 3rd March, 2014.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

The fun this week was Senate Estimates and the redoubtable Adjunct Professor Halton among other bureaucrats.

Other than that we have astonishing news on the lack of progress of the NBN and the costs so far and an increased tempo of warnings on the imminence on the arrival of major changes to Privacy rules.

This has prompted Coles to tell us.

Sharing of personal information

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We and Wesfarmers group companies may exchange your personal information with service providers engaged to assist with services including data processing, data analysis, information broking, credit reporting, online computing, printing, contact management, legal, accounting, business consulting, marketing, research, auditing, archival, delivery, security, investigation and mailing services, and in the provision of Coles-branded products and services such as payment cards and insurance..

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THE fate of a review into the much criticised personally controlled electronic health record (PCEHR) remains uncertain, with assistant health minister Fiona Nash raising doubts as to whether its findings would be made public.

The report, ordered by Health Minister Peter Dutton late last year, was handed to the minister’s office in late December.

However, it was reported this morning that when questioned over whether the report would be released, Ms Nash “couldn’t say if the findings would be made public”.

Mr Dutton’s office has since confirmed with MO that the minister has the report and that it remains under consideration.

However, MO’s subsequent queries about the report being made public and a potential deadline for its release received no direct answers.

Take-up of personally controlled e-health records (PCEHR) in Australia is on the rise, with 1.4 million customers registering for the service as of February 26.

Health Department e-health division first assistant secretary Linda Powell told Senate Estimates last night that 1.4 million consumers have registered since the launch in mid-2012, with the bulk of registrations coming from New South Wales, Victoria, and Queensland.

The drive in take-up, which is up from 900,000 in November last year, was largely due to public hospitals registering patients, she said. A total of 155 public hospitals across Australia are now using the system to upload discharge summaries.

Department secretary Jane Halton said that the public hospitals have been critical in getting customers on board.

THE Medical Software Industry Association has expressed disappointment at Medibank’s decision to close healthbook, its online personal health record system developed as part of the troubled $1 billion personally controlled e-health records program.

Medibank received $7.5 million in government funding as a Wave 2 site for the PCEHR system.

According to the insurer, people can store medical records securely and privately with healthbook. They can also choose to share it with family, friends or a Medibank nurse at no extra cost to members participating in a Better Health program.

Fifteen out of 52 computer hard drives purchased by the National Association for Information Destruction (NAID) Australia were found to have highly sensitive personal data including bank account details, medical information and home addresses.

The hard drives were taken to a forensic investigator, Insight Intelligence, who was able to easily extract the information. Some of the data included the legal case records of a family dispute, email files from a medical facility and signed documents granting access to business and personal emails from a Justice of the Peace.

NAID CEO Bob Johnson said the results were “very disturbing” in light of the Privacy Actreforms which are coming into law on 12 March 2014.

Significant changes to the Privacy Act 1988 will commence on 12 March 2014. The changes include a new set of harmonised Australian Privacy Principles (or APPs) that will replace the two sets of principles that currently apply to Australian Government agencies and to businesses. There will also be changes to credit reporting, including the introduction of a more ‘comprehensive credit reporting’ system and a simplified and enhanced correction and complaints process. The reforms also include new enforcement powers and remedies in relation to investigations.

The Office of the Australian Information Commissioner (OAIC) has adopted an enforcement approach to the reforms which recognises that Australian Government agencies and businesses are working hard to implement the new requirements. Our compliance focus in the months following 12 March 2014 will be on working with entities to ensure that they understand the new requirements and have the systems in place to meet them. In resolving matters brought to the attention of the OAIC we will take into account the steps taken by entities to genuinely prepare for the changes and to comply with the new legal requirements.

Sylvia Pennington

While plans to offload its commercial technology services arm CITEC are on track, the Queensland government has yet to produce a replacement schedule for major ICT systems it condemned as dangerously moribund two years ago.

An audit ordered by former Information Technology Minister Ros Bates in May 2012 identified 997 software and hardware flaws, whose replacement costs were put as high as $6 billion.

Replaced herself by current incumbent Ian Walker a year ago after a trouble prone stint at the helm, Ms Bates likened the state's IT infrastructure to a "1972 Ford Falcon clunker".

GERMAN scientists have harnessed physics to fight the flu, creating a computer model to help vaccine designers keep a step ahead of new strains.

Theoretical physicists from the University of Cologne have worked out a way of predicting how flus will evolve a year in advance. The new approach, reported today in the journal Nature, is based on an analysis of almost 4000 historical strains of influenza A virus.

Influenza A is one of the main seasonal flus that infect up to 15 per cent of the global population each year, killing up to 50,000 people in the US alone.

What’s wrong with Patient Testimonials?

Which post on the wall of the doctor’s Facebook page must be deleted? (Note: ‘Doctor’ can be replaced with ‘health professional’)

a. They made me wait for an hour and when I finally saw the doctor she rushed through the consultation and didn’t seem to care. I will never go to this practice again.

b. Thank you doctor for your kindness and excellent care. We are so glad our daughter has recovered; we will not forget what you have done for her.

The right answer should be: neither post. Good social media etiquette requires a response; deleting posts is generally not recommended. The real answer is: b.

By now most of us are familiar with the risks of social media. It is unfortunate that yet another peril has been added to the list: Australian Doctor magazine reported that doctors can be fined $5000 if a patient posts a testimonial on the doctor’s Facebook wall or other social media platform.

The Department of Veterans’ Affairs (DVA) In-Home Telemonitoring for Veterans Trial that started late last year in Armidale and Toowoomba has been extended to the NSW North Coast. The trial aims to determine if telemonitoring is a safe, effective and efficient complement to face-to-face GP consultations, and will contribute to providing better care for DVA Gold Card holders with high risk for admission. Veterans with chronic obstructive pulmonary disease, congestive heart failure, coronary artery heart disease or diabetes will have access to videoconferencing and remote monitoring of their vital signs by their usual surgery’s chronic disease nurse.

The trial, which will run until June 2015 extends the Department's existing Coordinated Veterans’ Care (CVC) Program. This program has proven very popular on the North Coast and provides funding to support coordinated care for eligible at risk DVA patients. Both projects hope to catch a deterioration in a patient's condition early so that emergency and possibly prolonged hospital admissions can be avoided.

One of the most common misconceptions out there about the FHIR is about the 80/20 rule we use when debating whether fields should be included in resources.

This is how I often hear it formulated:

FHIR only includes 80% of the elements that are used

But this is not correct – it’s not how the rule is formulated. This implies that the intent is to limit functionality, to ensure that it won’t actually work properly. That we prefer simplicity over actually solving the problem properly (e.g. we are externalising the complexity).

That’s not the intent at all. The intent absolutely is that FHIR supports 100% of the functionality that people use.

Life-saving potential of NSW-built platform honoured.

Former NSW Health CIO Greg Wells was named Healthcare CIO of the Year in Melbourne last night, in front of 160 of his peers attending the iTnews Benchmark Awards.

Wells was recognised for his work leading the establishment of NSW Health's HeatheNet platform, an application that interfaces between a multitude of hospital-based databases to automatically generate a simple, single portal for the clinician.

HealtheNet retrieves relevant data from any number of NSW health databases to a window tailored to each clinical specialty.

The Pharmacy Guild of Australia has defended a proposed in-store health check scheme for pharmacies, in response to an article published in The Conversation which claims that the scheme will not be effective in achieving integrated care.

Peter Breadon, Senior Associate at the Grattan Institute, outlined his concerns for the proposed program in the article, and emphasised that pharmacists need to do more than just one-off health checks.

“A one-off check would do little to achieve integrated care. It would basically leave us with the same old model, missing an opportunity to adapt to the rise of chronic disease,” Mr Breadon said.

“A growing number of people have chronic conditions such as diabetes, arthritis and heart disease – and they’re increasingly likely to have multiple health problems.

ALMOST $7 billion of government funds have been ploughed into the National Broadband Network to complete just 3 per cent of the rollout and NBN Co’s much-vaunted “Gigabit Nation” service does not have a single end-user customer.

NBN Co made the revelation about the turbocharged one-gigabit service during Senate estimates hearings yesterday, which Labor’s former communications minister Stephen Conroy had boasted would help drive productivity growth and create the jobs of the future.

It also emerged there was only one end customer on NBN Co’s 250 megabits-per-second service - which is one quarter of the speed of the gigabit service - in a fillip to the Coalition’s model of a cheaper, slower NBN.

While Labor had planned to provide super-fast optic fibre to the premises of 93 per cent of Australian homes, the Coalition is favouring fibre-to-the-node and will use Telstra’s existing copper network for the final few hundred metres to homes.

TAXPAYERS have been spending about $7300 per user to subsidise poorly performing satellite broadband services, the Coalition has declared, as NBN Co advances plans to fix problems with the service.

NBN Co executive chairman Ziggy Switkowski told a heated Senate estimates committee hearing on Tuesday that the interim satellite service left some people in regional and remote communities with services that were “subsistence level in a broadband world”.

Under the previous government, NBN Co purchased bandwidth on two satellites for $351 million to provide temporary services.

Dr Switkowski said some of the program “could until recently be criticised for not having been thought through in terms of some of the detail”.

A Harvard astronomer has a provocative hunch about what happened after the Big Bang.

Our universe is about 13 billion years old, and for roughly 3.5 billion of those years, life has been wriggling all over our planet. But what was going on in the universe before that time? It’s possible that there was a period shortly after the Big Bang when the entire universe was teeming with life. Harvard astronomer Avi Loeb calls this period the “habitable epoch,” and he believes that its existence changes how humans should understand our place in the cosmos.

We have one snapshot of life in the early universe, taken about 400,000 years after the Big Bang. This image is known as the Cosmic Microwave Background (CMB), and it’s what astronomers see when they aim their telescopes at the farthest edges of space, capturing light that has been traveling through the universe for billions of years—and from billions of years ago. Remember, light takes a while to reach Earth (it travels at only 186,000 miles per second), so the starlight you see in the sky at night is often thousands of years old. The CMB is a lot older than that. It’s from the time when the universe hadn’t yet developed stars.